Baby going backwards since started breast feeding

[pandw]

My baby was born seven weeks ago at 31 weeks gestation. For the first few weeks of her life she was fed EBM through a tube as she couldn't manage to suck and swallow.
While in hospital she progressed onto bottle feeding, but still struggled to latch on to me. I brought her home on bottles of EBM, but kept expressing and trying the breast feeding.

Almost a week ago she suddenly started latching on and feeding from the breast. She's not had a bottle since Friday. She is still having plenty of wet and dirty nappies and has been putting on weight (she gets weighed twice a week because of her prematurity).

My issue is that when she was on bottles she was feeding every four hours and (other than odd issues with wind) was very settled. Since we started breast feeding, she has varied between taking feeds every 2.5 hours and every 4 hours. She also possets after pretty much every feed. And she is still bringing up odd bits of milk up to 2-3 hours after a feed (by that time it is curdled). She is also much less settled when put down for a sleep.

I had put such emphasis on trying to get her onto the breast and now it feels like I would be better putting her back on bottles...

Sorry this has been so long. Does anybody have any thoughts??

pandw - you have had a difficult start and have done a great thing in maintaining bf under these circumstances...not easy at all.

Don't make the mistake of measuring feeding success by gaps between feeds It would be actually quite worrying if she went 4 hrs between breastfeeds - this is rarely sufficient for a young baby and rarely sufficient to keep up a milk supply.

It is fantastic that she needs a lot of settling and cuddling. This will overcome the separation she had from you by being born so early. She absolutely needs the extra contact and extra comfort she ensures she gets by staying awake and needing your closeness and 'agitating' and fussing in order to get it. This is normal behaviour and it should be celebrated

The possetting is normal, too.

Obviously her weight and progress need monitoring, but her physical needs for growth and nutrition are only a part of her development. She needs to develop socially and emotionally, and the more frequent feeding and the wakeful periods help with this.

A call to any of the breastfeeding lines would give you a chance to talk about this and find more confidence, I think.

Hope this helps.

Congratulations on your new baby

Feeding this often is (unfortunately!) very normal with a breastfed newborn. I understand it must be hard to make the change after having 4-hourly feeds when on bottles, and yes it probably would make your life easier in the short term to go back to bottlefeeding. But if you stick with it, you should find that the length of time between feeds increases after a few weeks, and it will be a lot easier to keep solely breastfeeding than expressing AND bottlefeeding. A lot of people find expressing long term to be hard work and it can be difficult to keep supply going, so if you keep going with the breastfeeding then your DD is likely to get the goodness of breastfeeding for longer.

To help you cope, have you thought about co-sleeping at all?

Breastfeeding is about so much more than just feeding a baby - she is obviously enjoying feeding from you, and wants to do more of it, which is great for both of you!

FWIW DD1 was born at 33 weeks and came home at 36 weeks. In hospital she was initially tube-fed, and then I breastfed her direct when I was rooming in before coming home. During this time she was going long periods (4 hrs) between feeds, which is often recommended for premmies I think in order to maximise sleep. However, once she was home she got more alert, and gradually started to feed more often - sometimes what felt like constantly! At the time this felt like going backwards, but with hindsight I think it was more that she was coming out of that very sleepy premmie state, and behaving more like a normal newborn, albeit at 6 weeks old, which was the time when she should have been born. It could easily have gone the same way if she had been FF.

Congratulations on the arrival of your DD, and for establishing breastfeeding!

Thanks for taking the time to reply.
When she was in hospital, the steps forward were things like increasing the amount of her feed and the time between feeds so it is hard for me now to change my thinking! I also connect her sleeping with her putting on weight, which is another thing we have been obsessed with.

I will keep going with the breast feeding for now, certainly for another few weeks. You are right Bertie, my supply was already starting to diminish with the expressing and feeding bottles, so that isn't a long term option for me.

I'm not comfortable with co-sleeping, I did read up on it but one of the risk factors is prematurity so I am going to avoid it, certainly for now.

Read your post with great interest, and all the replies too. I have now been expressing for my preemie for 18 weeks. A few weeks ago she suddenly latched on, but i have been too scared to stop expressing and giving her bottles as the routine we have is so good, 4 8oz bottles a day and sleeps 7-7. Don't want to disrupt that. Keep us updated with how you are getting on - give me the confidence that i can do it too!

Read your post with great interest, and all the replies too. I have now been expressing for my preemie for 18 weeks. A few weeks ago she suddenly latched on, but i have been too scared to stop expressing and giving her bottles as the routine we have is so good, 4 8oz bottles a day and sleeps 7-7. Don't want to disrupt that. Keep us updated with how you are getting on - give me the confidence that i can do it too!

Hi Sugarmuppet.
Yes it was a leap of faith to stop the bottles but i had a lot of support from the hospital consultant and my health visitor plus my mum was staying at the time and being v supportive.
My baby is only the equivalent of 38 weeks gestation so even on bottles, she was still up in the night - but she was very firmly in a four hourly routine.

Now, to give you an example, she fed 8pm and 11:30pm last night, then 2:30am, 6:00am, 8:30am and now 12:30. So she does sometimes go four hours between feeds, but not on a regular basis. She is also less settled between feeds than she used to be - maybe because she has been enjoying the closeness of breast feeding and objects to being put down! So, for example after her 11:30pm feed, I didn't get her down till 1:30am.

I will try to pop back on a roughly weekly basis to let you know how she is doing re routine etc.

Best of luck! And enjoy your wee one! At 18 weeks mine is now nearly 10lb, its amazing how preemies come on and how fast they change!

Hope things continue to go well, pandw. Having a pre-term baby who then becomes a full-term baby is a major change...term babies being firmly in 4-hourly routines are not usual, or necessarily doing the 'right' thing. We really don't want term babies feeding to a rigid routine (unless they make it clear this is what they prefer) because it is not good for milk supply, and not consistent with what we know most babies' emotional and physical needs are.

We also want them to 'ask' for attention to to show by their behaviour they need love and calming cuddles - that is a good sign they are understanding the need for loving contact and that they want to get close and to know you. This would not be appropriate for tiny pre-termers - their need is to grow with minimal energy expenditure.

Please don't think of 4-hrly as a target now. It's not a sign of anything at all. Of course she loves the closeness of bf, and of course she prefers to be in your arms - that's all normal and all good and forms a good basis for her learning, understanding, social and emotional development, and her relationships with the people who love her.

It is excellent that she wants to feed so much!

DS2 is a right chubber and has managed this by being pretty much permanently attached. It is a lot easier to get your head around feeding them whenever they want (even if it is only 20 minutes after the last time) than it is to try to get them to fit any sort of pattern.

I don't even notice anymore.

Your baby is being an absolutely normal, healthy, happy breastfeeding newborn.

My experience was very similar to yours. It's time to stop watching the clock and monitoring like a nurse, and start just going with her flow, enjoying and trusting her to feed when she needs to. I know it's hard to make that transition!

Ah pandw, your baby sounds like she is doing brilliantly. Breastfeeding is so much more than just feeding though, it's also about comfort too.

Hey, tiktok has said it already in her previous posts and much more eloquently and to the point than I ever could. But please don't feel like she's going backwards.

The above ladies have given you excellent feeding advice so I won't add to it, but I just want to tell you how fantastic you are for breastfeeding despite an 'unfavourable' start. All those antibodies and calories will have given her such a fantastic start

Have you got a sling btw? Being tucked up next to you (in a stretchy wrap for example) where she can feel your warmth and hear your heartbeat should help settle her between feeds

My 3 DC have never gone 4 hours on a breastfeed during the day more likely to be 2.5 to 3 hours, but today think I have fed him 2 hourly - think he's having a gorwth spurt! - he's now 8 weeks.

I agree with the comments re: 4 hourly routine - its not normal for BF baby. I do aim for a 3 hourly routine all things being equal (ie I will not let him go more than 3 hours in the day) but when he's hungry before the three hours are up I'll fed him.

Posseting is totally normal - as breastfeeding is so nice and comforting they often take a bit more than they need. Wind her regularly during the feed.

Think it sounds like you are doing really well